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首都医科大学附属北京同仁医院血液透析中心
纸质出版日期:2021,
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王利娟, 梁巧静, 孙晓媚, 等. 碳酸镧联合低钙透析对高龄维持性血液透析患者钙磷代谢和全段甲状旁腺激素的影响[J]. 中国医院用药评价与分析, 2021,21(8):959-962.
WANG Lijuan, LIANG Qiaojing, SUN Xiaomei, et al. Effects of Lanthanum Carbonate Combined with Low Calcium Dialysis on Calcium and Intact Phosphorus Metabolism and Parathyroid Hormone in Elderly Patients with Maintenance Hemodialysis[J]. 2021,21(8):959-962.
王利娟, 梁巧静, 孙晓媚, 等. 碳酸镧联合低钙透析对高龄维持性血液透析患者钙磷代谢和全段甲状旁腺激素的影响[J]. 中国医院用药评价与分析, 2021,21(8):959-962. DOI: 10.14009/j.issn.1672-2124.2021.08.015.
WANG Lijuan, LIANG Qiaojing, SUN Xiaomei, et al. Effects of Lanthanum Carbonate Combined with Low Calcium Dialysis on Calcium and Intact Phosphorus Metabolism and Parathyroid Hormone in Elderly Patients with Maintenance Hemodialysis[J]. 2021,21(8):959-962. DOI: 10.14009/j.issn.1672-2124.2021.08.015.
目的:探讨碳酸镧联合低钙透析对高龄维持性血液透析患者钙磷代谢和全段甲状旁腺激素(i PTH)的影响。方法:选取2019年1月至2020年3月首都医科大学附属北京同仁医院血液透析中心收治的高龄维持性血液透析患者60例作为研究对象
按随机数字表法分为两组。观察组30例患者采用碳酸镧联合低钙透析治疗
对照组30例患者采用碳酸钙联合低钙透析治疗。观察、记录两组患者治疗前
治疗后1、2和3个月的血钙水平、血磷水平、钙磷乘积、i PTH水平和不良反应发生情况
并进行统计学分析。结果:观察组患者治疗后的血钙水平、血磷水平和钙磷乘积较治疗前明显降低
差异均有统计学意义(P<0.05);对照组患者治疗后的血钙水平、血磷水平和钙磷乘积与治疗前比较
差异均无统计学意义(P>0.05);治疗后
两组患者上述指标水平比较
差异均有统计学意义(P<0.05)。两组患者治疗后的i PTH水平均较治疗前明显降低
但观察组患者降低幅度更明显
差异均有统计学意义(P<0.05)。观察组患者的不良反应总发生率为33.33%(10/30)
显著高于对照组的6.67%(2/30)
差异有统计意义(P<0.05)。结论:碳酸镧联合低钙透析能够有效降低高龄维持性血液透析患者的血钙、血磷、钙磷乘积和i PTH水平
有助于纠正高钙及高磷血症、预防甲状旁腺功能亢进和调节骨物质代谢异常以防止低转化骨病
但不良反应发生率稍高
临床应用中应注意不良反应的防治。
OBJECTIVE: To probe into the effects of lanthanum carbonate combined with low calcium dialysis on calcium and phosphorus metabolism and intact parathyroid hormone( i PTH) in elderly patients with maintenance hemodialysis. METHODS: Totally 60 elderly patients with maintenance hemodialysis admitted into Hemodialysis Center
Beijing Tongren Hospital
Capital Medical University from Jan. 2019 to Mar. 2020 were extracted to be divided into two groups via the random number table. The observation group( n = 30) was treated with low calcium dialysis combined with lanthanum carbonate
while the control group( n = 30) received low calcium dialysis combined with calcium carbonate. The serum calcium
serum phosphorus
calcium phosphorus product
i PTH and adverse drug reactions of two groups were observed and recorded before treatment
after treatment of 1 month
2 months and 3 months. And statistical analysis was performed. RESULTS: The serum calcium
serum phosphorus and calcium phosphorus product of the observation group after treatment were significantly lower than those before treatment
and the difference was statistically significant( P < 0. 05). Compared with before treatment
there was no statistically significant difference in serum calcium
serum phosphorus and calcium-phosphorus product in the control group after treatment( P > 0. 05). The difference of the above indicators after treatment between two groups was statistically significant( P< 0. 05). After treatment
the levels of i PTH in two groups were significantly lower than those before treatment
yet the reduction in the observation group was more significant
and the difference was statistically significant( P< 0. 05). The total incidence of adverse drug reactions in the observation group was 33. 33%( 10/30)
significantly higher than that in the control group( 6. 67%
2/30)
the difference was statistically significant( P <0. 05). CONCLUSIONS: Lanthanum carbonate combined with low calcium dialysis can effectively reduce the serum calcium
serum phosphorus
calcium phosphorus product and i PTH in elderly patients with maintenance hemodialysis
which can help to correct the hypercalcemia and hyperphosphatemia
prevent the hyperparathyroidism and regulate the abnormal bone material metabolism to avoid hypotransformation bone disease
yet the incidence of adverse drug reactions is slightly higher
and attention should be paid to the prevention and control of adverse drug reactions in clinical application.
高龄维持性血液透析碳酸镧钙磷代谢全段甲状旁腺激素
ElderlyMaintenance hemodialysisLanthanum carbonateCalcium and phosphorus metabolismIntact parathyroid hormone
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